Li Qing, Zhang Yuan, Ding Ding, Yang Yunou, Chen Qian, Liu Chaoqun, Li Xinrui, Hong Changjiang, Ling Wenhua
Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Cardiology. 2016;134(3):347-56. doi: 10.1159/000443518. Epub 2016 Mar 18.
Several studies have investigated the association between serum uric acid (SUA) and the risks of coronary artery disease (CAD) but have yielded inconsistent results. The aim of this study was to assess whether there is an independent association of SUA with all-cause and cardiovascular disease (CVD) mortality in Chinese patients with CAD.
A prospective cohort study of 1,799 patients was conducted. Cox regression models were used to estimate the association of SUA with the risk of death.
During a median follow-up of 3.9 years, 177 deaths were recorded and 126 of these were due to CVD. Patients in the highest SUA quartile had a 2.43-fold risk of all-cause mortality and a 2.44-fold risk of CVD mortality compared with those in the lowest quartile. In the subpopulation analysis, the association between SUA and mortality remained similar when participants were stratified by age, gender, body mass index and type of CAD. In contrast, we found a significant interaction with estimated glomerular filtration rate (eGFR). There was a stronger association between SUA and the risk of all-cause and CVD mortality among patients with an eGFR ≥60 ml/min/1.73 m2, but no significant association was found in the population with an eGFR <60 ml/min/1.73 m2.
Elevated SUA levels were positively associated with an increased risk of all-cause and CVD mortality among CAD patients.
多项研究调查了血清尿酸（SUA）与冠状动脉疾病（CAD）风险之间的关联，但结果并不一致。本研究旨在评估在中国CAD患者中，SUA与全因死亡率和心血管疾病（CVD）死亡率之间是否存在独立关联。
对1799例患者进行了一项前瞻性队列研究。采用Cox回归模型估计SUA与死亡风险之间的关联。
在中位随访3.9年期间，记录了177例死亡病例，其中126例死于CVD。与最低四分位数的患者相比，SUA最高四分位数的患者全因死亡率风险高2.43倍，CVD死亡率风险高2.44倍。在亚组分析中，当按年龄、性别、体重指数和CAD类型对参与者进行分层时，SUA与死亡率之间的关联仍然相似。相比之下，我们发现与估计肾小球滤过率（eGFR）存在显著交互作用。在eGFR≥60 ml/min/1.73 m2的患者中，SUA与全因和CVD死亡率风险之间的关联更强，但在eGFR<60 ml/min/1.73 m2的人群中未发现显著关联。
CAD患者中SUA水平升高与全因和CVD死亡率风险增加呈正相关。
